A Case of J Wave Syndrome Successfully Resuscitated from Cardiac Arrest Followed by Prominent J Wave Augmentation

概要

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The presence of J wave is associated with a risk for the sudden death, and termed J wave syndrome. A 37-year-old male was referred to our hospital for an ICD implant for secondary prevention. He did not have a history of syncope or family history of sudden death but experienced an episode of cardiac arrest during deskwork at midnight. Ambulance was called and bystander CPR was performed by his wife while waiting for the arrival. A record of AED showed successful defibrillation of VF by multiple DC shocks. However, the prominent J wave was apparent post-VF. The J wave was augmented during mild hypothermia therapy after admission to the hospital but persisted during his hospital course. He recovered without any neurological deficit and the rest of his clinical course was uneventful. Intensive examination excluded structural heart diseases and VF was not induced by programmed electrical stimulation during EP study. Furthermore, an intravenous administration of pilsicainide did not disclose coved type ST elevation and signal averaged ECG was negative. He had an ICD implant and had no recurrence during 4-year follow up period. This is an interesting case of J wave syndrome whose J wave remained continuously but augmented during VF storm.